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Jared Dale Clark, APN
Gerontology Nurse Practitioner in Texarkana, Arkansas
NPI 1467011239

Jared Dale Clark is a Gerontology Nurse Practitioner based in Marshall, AR and is specialized in Gerontology. Jared Dale Clark practices in Texarkana, AR and has the professional credentials of APN. The NPI Number for Jared Dale Clark is 1467011239 and holds a License No. AP141588 (Arkansas).

The current practice location address for Jared Dale Clark is 4077 Jefferson Ave, Texarkana, AR and can be reached out via phone at 870-330-9200. You can also correspond with Jared Dale Clark through the mailing address at PO BOX 1326, MARSHALL, TX - 75671-1326 (mailing address contact number: 903-927-3782).

Location: 4077 Jefferson Ave, Texarkana, AR, 75671-1326
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Provider Profile Details
NPI Number
1467011239
Provider Name
Jared Dale Clark
Credential
APN
Provider Entity Type
Individual
Gender
Male
Address
4077 Jefferson Ave, Texarkana, AR, 75671-1326
Phone Number
870-330-9200
Fax Number
Provider Enumeration Date
06/06/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AP141588 01 TX APN LICENSE
institution
Provider Business Practice Location Address Details
Address
4077 Jefferson Ave
City
State
Zip
71854-1509
Phone Number
870-330-9200
Fax Number
person
Provider Business Mailing Address Details
Address
4077 Jefferson Ave
City
State
Zip
71854-1509
Phone Number
870-330-9200
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
License No.
AP141588 (Texas)
Definition
Definition to come...
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